CLINICAL RESEARCH
Lipoprotein(a) is associated with left ventricular systolic dysfunction in a Chinese population of patients with hypertension and without coronary artery disease
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Submission date: 2015-12-25
Final revision date: 2016-03-29
Acceptance date: 2016-04-13
Online publication date: 2016-05-12
Publication date: 2017-07-28
Arch Med Sci 2017;13(5):1078-1085
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ABSTRACT
Introduction: Data on relationship between lipoprotein(a) [Lp(a)] and non-ischemic heart dysfunction are limited. This study is aimed to assess the association between Lp(a) and left ventricular systolic dysfunction in a Chinese population of patients with hypertension and without coronary artery disease (CAD).
Material and methods: This cross-sectional study included 1611 patients with hypertension and without CAD in China. The factors associated with left ventricular ejection fraction (LVEF) were evaluated using univariate and multivariate analysis.
Results: A higher percentage of hypertensive patients with LVEF<50% were men, and had lower plasma high-density lipoprotein cholesterol, but higher plasma Lp(a), serum creatinine, and hemoglobin levels than those with LVEF ≥ 50% using univariate analysis. When participants were classified as four groups according to Lp(a) quartiles, LVEF was decreased with increased Lp(a) levels. The prevalence of LVEF < 50% was increased with Lp(a) quartiles. Multiple linear regression analysis indicated that plasma Lp(a) levels, man, and serum creatinine levels were independently correlated with LVEF in hypertensive patients. Multiple logistic regression analysis indicated that plasma Lp(a) levels (OR = 5.566, 95% CI: 1.745–17.758, p = 0.004) or Lp(a) quartiles (Quartile 4: OR = 3.234, 95% CI: 1.290–8.105, quartile 1 as reference, p = 0.012) was independently correlated with LVEF < 50% with adjustment for other potential confounders. Ordinal logistic regression analysis demonstrated that Lp(a) (OR = 5.760, 95% CI: 1.831–18.120, p = 0.003) was independently correlated with different LVEF categories (≥ 50%, 35–49%, and < 35%) in hypertensive patients.
Conclusions: Left ventricular ejection fraction is decreased with increased plasma Lp(a) levels. Lipoprotein(a) is independently correlated with left ventricular systolic dysfunction in patients with hypertension and without CAD.